胃と腸53巻11号

2018年10月発行

今月の主題 胃拡大内視鏡が変えたclinical practice 主題

拡大内視鏡が慢性胃炎の診断をどう変えたか

著者： 大森正泰¹ 上堂文也¹ 神崎洋光² 岩坪太郎¹ 中平博子¹ 松浦倫子¹ 七條智聖¹ 前川聡¹ 金坂卓¹ 山本幸子¹ 竹内洋司¹ 東野晃治¹ 石原立¹ 冨田裕彦³

所属機関： ¹大阪国際がんセンター消化管内科 ²岡山大学大学院医歯薬学総合研究科消化器・肝臓内科学 ³国際医療福祉大学医学部病理学

ページ範囲：P.1438 - P.1444

要旨●胃癌リスクに応じた上部消化管内視鏡のサーベイランス間隔を考慮するうえで，腸上皮化生の診断は重要である．腸上皮化生の存在診断に関しては，有用な拡大観察所見が複数報告されている一方で，内視鏡画像の鮮明化に伴い非拡大観察での診断能も向上している．腸上皮化生のうち不完全型腸上皮化生は完全型腸上皮化生に比べ胃癌発生リスクがより高いとする報告が多く，筆者らはNBI併用の拡大観察を用い，微細粘膜構造と腸上皮化生サブタイプの関連性を検討した．NBI拡大観察で畝状の表面構造が優勢である腸上皮化生は，不完全型である割合が高い傾向にあったが，正確な鑑別は困難であった．

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